Friday, December 16, 2016

1867: The four best nebulizers

By 1867 there was quite a selection of nebulizers to choose from. Dr. John Stutter described four of the most significant ones in his 1867 book "On the use of medicated inhalations in the treatment of respiratory organ."  

The four nebulizers were as follows:  (see 1, pages 26-36):

Elsberg's Nebulizer
1.  Elsberg's Nebulizer:  "The simplest instrument is that known as "Elsberg's Nebulizer," Stutter said, which consists of two hard rubber tubes pointed at the extremities, the openings being small, and so hinged that they can be placed at right angles, the openings being immediately opposite, as in Fig. 3. One arm of the apparatus being placed in the medicated fluid, blowing through the other causes the fluid to rise in the tube, and it is carried off" in a fine spray. Rimmel's Rafraichisseur, which is the same in principle, has been employed for some years for distributing perfumes, and may be purchased quite cheap. The principal objection to this method is, that it requires a second party, and the breath cannot but prove offensive to many patients."

Sales-Giron's Nebulizer
2.  Sales-Giron Nebulizer:  "The second form of apparatus consists of a cylinder in which works an air tight piston, like the barrel of a syringe," said Stutter.  "Fluid being placed in it, is forced through minute openings in the nozzle, as a delicate spray.  Fig. 4, represents the instrument of M. Sales Giron, which I have used in my practice with excellent results. When inhalations are much used, I have no doubt they will be manufactured by our hard rubber manufacturers, at a price to bring them within the reach of all"  This nebulizer required lots of work to get a mist, and sometimes may have required two people if the person needing the medicine was too sick.  For this reason it probably wasn't very marketable.  This nebulizer was often listed as the first nebulizer, and for that reason I wrote about it in greater detail here.

3.   Dr. Mackenzie's Nebulizer:  "The apparatus (called the eclectic inhaler) of Dr. Mackenzie," said Dr. Stutter, "is a very good one. The piston is drawn back by a wheel and rack at its upper part, and is forced down by a circular spring which surrounds the cylinder. The apparatus is filled with liquid by a funnel in its top, and all the spray, except that which is inhaled, passes back into the apparatus. He claims the following advantages for  it:  1. Its simplicity, requiring only a few turns of a handle to set it in operation. 2. The extremely fine state of subdivision which it effects. 3. The uniform pressure exerted. 4. The fact that the Waste liquid returns into the apparatus. 5. The ease with which it can be taken to pieces and cleaned."  (no picture available in Dr. Stutter's book, although I wrote about the inhaler here.  I will write about Dr. Mackenzie in an upcoming post.)

Dr. Seigle's Inhaler
4.  Dr. Seigle's Inhaler:  "The third form of apparatus is that of Dr. Seigle, and is preferable to the others, for its simplicity and because it is automatic. The best reason for preferring it, however, is, that its price is such as to bring it within the means of any patient, as it is furnished through the druggists for $5,00, and its construction is so simple, that it is readily operated by any one."  The inhaler (or nebulizer) was designed so that steam delivered the medicine to the patient, so that no assistance, nor cranking, was needed.  I describe this inhaler in more detail here.

So while there were many varieties of mist inhalers, these were your basic nebulizers of this era, at least according to Dr. Stutter.  This was basically what you had to deal with until the 1930s when electricity became available. It was either one of these or inhaling smoke, which was another common remedy for difficult breathing.

References:
  1. Scudder, John Milton, " On the use of medicated Inhalations in the treatment of diseases of the respiratory organs," 1867, Cincinnati, 2nd edition, Moor, Wilstach, and Baldwin
  2. Wyka, Kenneth A., Paul Joseph Mathews, William F. Clark, "Foundations of Respiratory Care,"
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